Massive pleural effusion due to IgG-Kappa subtype multiple myeloma: A case report

Arunsurat, Itthiphat; Reechaipichitkul, Wipa; So-ngern, Apichart; Ungareevittaya, Piti; Chaisuriya, Nipon; Teawtrakul, Nattiya; Ratanawatkul, Pailin; Chumpangern, Worawat

doi:10.1016/j.rmcr.2019.100984

Cited by 2 publications

(6 citation statements)

References 16 publications

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“…[5] Only 6% of myeloma patients will experience pleural effusion. [3,6] and is usually brought on by nephrotic syndrome, pulmonary embolism, congestive heart failure due to amyloidosis, and infection. [3,7] Less than 1% of instances of myelomatous pleural effusion are recorded.…”

Section: Figure 3 Shows the Results Of Case 1 Sr Protein Electrophore...mentioning

confidence: 99%

“…[3,7] Less than 1% of instances of myelomatous pleural effusion are recorded. [3,6,7] Myelomatous effusion's pathophysiology is still a mystery. There are several proposed pathways for myelomatous pleural effusion.…”

Section: Figure 3 Shows the Results Of Case 1 Sr Protein Electrophore...mentioning

confidence: 99%

“…[7] Cardiac failure has been the most frequent cause of effusion in PCM among these several etiological causes. [6,7] The pleural fluid profile in the majority of MPE cases is exudate (97.4%) and lymphocytic (78.6%). [3] Peritoneal involvement with ascites is one of the extramedullary involvements of MM that is highly uncommon, and only a few numbers of instances have been documented.…”

Section: Figure 3 Shows the Results Of Case 1 Sr Protein Electrophore...mentioning

confidence: 99%

“…[4] Rodriguez et al reported the first incidence of (MPE) in 1994. [5,6] Pleural effusion is a rare sign of PCM that typically appears later in the course of the disease and is typically brought on by another disease process. The identification of atypical plasma cells in pleural fluid cytology, the demonstration of the monoclonal protein in pleural fluid electrophoresis, and histologic confirmation with biopsy are the diagnostic criteria to confirm the myelomatous aetiology.…”

Section: Figure 3 Shows the Results Of Case 1 Sr Protein Electrophore...mentioning

confidence: 99%

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Reactive Plasmacytosis in Effusions - Not A Rare Occurrence

Naik,

Kulkarni,

Khedkar

2023

Int J Health Sci Res

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Introduction: Effusions with plasma cells are uncommon. In such effusions reactive plasma cells need to be differentiated from malignant ones. In the literature we came across a single case of plasmacytic effusion in the absence of underlying malignancy. Material and methods: A retrospective analysis of the ascitic and pleural fluid samples received for routine analysis, from Jan 2021 to Dec 2022 was done. Result: Five cases were incidentally detected to have reactive plasmacytosis in effusions, three in pleural fluid and two in ascitic fluid. Number of plasma cells varied between 2% to 30%. In all these cases thorough clinical details were obtained and relevant investigations were studied. All the cases had ailments related to hepatobiliary system. None of these cases had any features of lymphoma or plasma cell neoplasm. In all the cases plasma cells had a reactive morphology. In one of the cases the reason for reactive plasmacytosis was viral hepatitis, in another case it was suspected to be tuberculosis. In two cases some intercurrent infection could be the cause for reactive plasmacytosis in effusion. However, in one case the patient passed away before proper investigations could be made. Discussion: The mechanism for reactive plasmacytosis is not documented yet. Further studies in this regard are needed as the entity is not rare. In our study the incidence was 0.36% (5 cases out of a total of 1397 cases). Key words: Effusions, plasma cells, reactive

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Section: Figure 3 Shows the Results Of Case 1 Sr Protein Electrophore...mentioning

confidence: 99%

Section: Figure 3 Shows the Results Of Case 1 Sr Protein Electrophore...mentioning

confidence: 99%

Section: Figure 3 Shows the Results Of Case 1 Sr Protein Electrophore...mentioning

confidence: 99%

Section: Figure 3 Shows the Results Of Case 1 Sr Protein Electrophore...mentioning

confidence: 99%

See 2 more Smart Citations

Reactive Plasmacytosis in Effusions - Not A Rare Occurrence

Naik,

Kulkarni,

Khedkar

2023

Int J Health Sci Res

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“…MPE was predominantly unilateral (63.9%) and usually involved more than two-third of hemithorax (54.5%). In most cases of MPE, the pleural fluid profile is lymphocytic (78.6%) and exudate (97.4%) [ 11 , 12 ]. Upon literature review of English case reports about pleural effusion and MM, there were 17 cases of MPE as initial presentation of MM.…”

Section: Discussionmentioning

confidence: 99%

Transient Pleural Fluid Infiltration by Clonal Plasma Cells Associated with Pulmonary Tuberculosis

et al. 2020

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Pleural effusion is a rare presentation of plasma cell myeloma, occurring in around 6% of patients during the course of their disease, most commonly as a consequence of a concurrent disease process like heart failure secondary to amyloid deposition. Direct infiltration of the pleural fluid by malignant cells leading to myelomatous pleural effusion is a rare mechanism occurring in less than 1% of patients with plasma cell myeloma, and it is associated with a worse prognosis. There are few case reports of myelomatous pleural effusion as an initial presentation of multiple myeloma. Pleural fluid infiltration by monoclonal plasma cells in the absence of an underlying plasma cell myeloma was not reported before in the literature. Tuberculosis is a known cause of polyclonal gammaglobulinemia, however few case reports described the coexistence of monoclonal gammopathy of undetermined significance and tuberculosis. Here we present an interesting case of pleural fluid infiltration by an abnormal looking clonal plasma cells associated with active pulmonary tuberculosis and parapneumonic effusion in a patient with a background of acute myeloid leukemia. Interestingly, the clonal plasma cell proliferation was confined to the pleural fluid without any evidence of an underlying plasma cell neoplasms (including monoclonal gammopathy of undetermined significance and plasmacytomas). Since our patient had an underlying meyloid neoplasm, we though about the possibility of secondary malignancy. However, in almost all patients with coexisting

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Massive pleural effusion due to IgG-Kappa subtype multiple myeloma: A case report

Cited by 2 publications

References 16 publications

Reactive Plasmacytosis in Effusions - Not A Rare Occurrence

Reactive Plasmacytosis in Effusions - Not A Rare Occurrence

Transient Pleural Fluid Infiltration by Clonal Plasma Cells Associated with Pulmonary Tuberculosis

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